<!doctype html>
<html lang="es">
<head>
	<meta charset="UTF-8">
	<title>Nivel Basico</title>
	<link rel="stylesheet" type="text/css" href="../css/estilos.css"  media="screen" />
    <style type="text/css">
<!--
.Estilo1 {color: #666666}
-->
    </style>
</head>
<body>
	<header>
<center><h1>Ingresa tus datos </h1></center>
	</header>

<aside>
	
<form id ="form-order" action="Registrarse.php" method="post">
	
	<center>
	  <p>&nbsp; </p>
	  <p>Nombre: 
	    <input type="text" name="nombre" id="nombre"
		placeholder=" "
		autofocus 
		autocomplete
		required>
	  </p>
	  <p>&nbsp;</p>
	</center>
	
	<center>
	  <p> Apellido: 
      <input type="text" name="apellido" id="apellido"
		placeholder=" "
		autofocus 
		autocomplete
		required></p>
	  <p>&nbsp;</p>
	</center>
	
	<center>
	  <p> Correo:  
      <input type="text" name="correo" id="correo"
		placeholder=" "
		autofocus 
		autocomplete
		required></p>
	  <p>&nbsp;</p>
	</center>

	<center>
	  <p> Usuario :   
	    <input type="text" name="usuario" id="usuario"
		placeholder=" "
		autofocus 
		autocomplete
		required></p>
	  <p>&nbsp;</p>
	</center>
	
	<center>
	  <p> Contraseña
	    <input type="password" name="clave" id="clave"
		placeholder=" "
		autofocus 
		autocomplete
		required></p>
	  <p>&nbsp;</p>
	</center>
		
	
	

	<center><input type="submit" value="Enviar"></center>

</form>

</aside>
<p>&nbsp; </p>
<table width="1380" height="49" border="1">
  <tr>
    <td><div align="center" class="Estilo1"> UTPL @2013 </div></td>
  </tr>
</table>
<p>&nbsp;</p>
<footer>

	<footer>
</body>
</html>